EXCLUSIVE: Four NHS trusts in five have lost patient data or suffered a data security breach since the beginning of last year, Pulse can reveal.

Our investigation reveals the true scale of confidentiality breaches within the NHS, with trusts reporting more than 1,300 incidents since January 2007.

GPs warned the findings would further undermine confidence in plans for electronic care records, with many of the data breaches involving NHS IT.

Figures obtained the Freedom of Information Act from 162 PCTs, hospital trusts and NHS authorities showed that there had been 557 incidents of lost data and 794 breaches of confidentiality over the time period.

Just 32 out of 162 trusts surveyed said they had not had a data loss or security breach incident. …

These include theft of patients’ letters, changes to spouses’ medical records, posting of pictures of patients to Facebook…

Millions of Catholic and Muslim patients could opt out of having electronic care records because their data may be used without explicit consent for research purposes contrary to their faiths, Pulse has learned.

The Catholic Bishops’ Conference of England and Wales has condemned as ‘unacceptable’ the Government’s proposals for a massive expansion in the use of patient records for research purposes.

Under the plans, currently being consulted upon, patients who have given implied consent for a Summary Care Record to be created for them will not be asked for further consent before their data is shared.

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A spokesperson for Connecting for Health said: ‘Patients can say they do not want to have their records held for research – this would involve them making a formal request, under the Data Protection Act, for identifiable data to be removed on the grounds that its presence there causes distress and we would, of course, act on such a request.’

Some of the surveillance team did not have copies of the photographs of Osman. McDowall does not know why.

The first surveillance team leader’s (Derek, Red team) concerns were not being relayed from the operations room up the heirarchy to the Gold commander, McDowall, who was responsible for overall strategy. In turn McDowall’s strategy lost usefulness because key elements of it (firearms team) weren’t present and key assumptions (that 21 Scotia Road was one building not part of a block of flats) were wrong. Also, key objectives (stop everyone who leaves the building) weren’t met. They could have got a map of the area but didn’t.

The two top people at Scotland Yard were on a break – there was no obvious choice for Silver. A significant number of firearms officers were on annual leave.

A vehicle known to be connected with the 21/7 bombers was parked opposite the entrance to the block. The police were supposed to stop those who left the block from getting to public transport. Yet they had no tactic to deal with those who left by vehicle.

When McDowell made his decisions relating to firearms, he did not know what was possible on a firearms front. A sensitive document, Firearms Tactical Options (see pages 118-121 of 29 September transcript), drafted by two firearms tactical advisors in the early hours of that morning, lists the options available to firearms officers with regard to general terrorism as well as suicide terrorism, listing nine options based on the fact that someone has been identified as a bomber – whether they are stop, contain, challenge and so on – and the resources available for each one. There has been no training in six of those nine options. Regardless, McDowell says he didn’t see this document.

Michael Mansfield QC, for the family, established that it was possible for the police to covertly (that is, without being seen from Scotia Road) to stop people before they got on public transport or left the area by other means.

From all this, the allegation (by Mansfield) is that McDowall’s strategy should have been revised to reflect the reality on the ground – however, it had not been revised since its development in the early hours of that morning. McDowell claims he was not made aware of the issues on the ground. Nor was Cressida Dick made aware of all the issues.

As for the type of ammunition, its use had not been authorised by the Home Office, but nevertheless it is routinely used by Met firearms teams. Now, I do not know whether use of a particular type of ammunition is required to be authorised by the Home Office, or whether it is a matter (as per other police decisions) for the specific police in question. What is a concern is that there seems to be a lack of accountability here – as far as I can see there has been no discussion of this in Parliament. (Although it seems to be moot – they fired a number of bullets at de Menezes’s head with the intention of killing him*.)

Horwell for the Commissioner and McDowell agreed that if McDowell had been made aware of those issues there is very little that he would have done differently. However Mansfield pointed out that in the Health and Safety trial McDowall agreed there were some things he would have done differently. [So we will have to look at that in detail.]

Horwell raised some points about the behaviour of de Menezes – in particular, getting off and on the bus at Brixton tube station, “a classic anti-surveillance technique employed by the IRA, al Qaeda, and significant criminals”. This relates to a question I’ve asked several times – when you are suspicious of someone, does their every action look suspicious? He got off and on the bus because Brixton tube was closed. Did the surveillance team not make each other and the control room aware that Brixton tube was closed? Did the control room not look on Transport for London’s journey planner to see if Brixton tube was closed?

* They claim the intention is to ‘incapacitate’ – I think this is an abuse of the English language. The word ‘incapacitate’ means to disable or render incapable, not kill. I think you’d be hard pushed to explain to a judge that when you fired several bullets at a person’s head you only intended to incapacitate him as opposed to kill him. Let’s be honest and adult with the language. If they shot at his body or limbsthen I accept that it was to incapacitate – at his head, it’s going to kill. (As an aside, if I commit GBH and and the result is my victim’s unlawful killing that is murder.)